Lifeguard Effectiveness: A Report of the Working Group

Lifeguard Effectiveness: 

A Report of the Working Group 

Editors: Christine M. Branche, Ph.D. 

Steven Stewart, M.S. 

Division of Unintentional Injury Prevention 

National Center for Injury Prevention and Control 

Centers for Disease Control and Prevention 

Department of Health and Human Services

Lifeguard Effectiveness: A Report of the Working Group is a publication of the National 

Center for Injury Prevention and the Centers for Disease Control and Prevention 


Jeffrey P. Koplan, M.D., M.P.H., Director 


Sue Binder, M.D., Director 


Christine M. Branche, Ph.D., Director 

Production services were provided by staff of the Management Analysis and Services 

Office, CDC. 

Suggested Citation: Branche CM, Stewart S. (Editors). Lifeguard Effectiveness: A Report of 

the Working Group. Atlanta: Centers for Disease Control and Prevention, National Center 

for Injury Prevention and Control; 2001. 

ii 

Lifeguard Effectiveness: A Report of the Working Group

Table of Contents 

Contributing Authors ................................................................................................................... v 

Executive Summary.................................................................................................................... vii 

Introduction................................................................................................................................... 1 

A Brief History and Background of Lifeguarding Services in the United States................... 3 

Events Describing the Efficacy of Lifeguarding Services 

in Preventing Drowning Deaths ............................................................................................ 5 

Patron Surveillance: A Key Component of Lifeguarding Services.......................................... 7 

Use of Design Criteria to Reduce Drownings at Lakefront Facilities...................................... 9 

The Economic Costs of Drowning Deaths ............................................................................... 11 

Legal Implications of Providing Lifeguard Protection............................................................ 13 

Decision Maker’s Guide to Lifeguard Protection .................................................................... 15 

Summary and Conclusions........................................................................................................ 17 

References ................................................................................................................................... 18 

Resource Guide........................................................................................................................... 19 

Appendix...................................................................................................................................... 21 

Lifeguard Effectiveness: A Report of the Working Group 

iii

Contributing Authors 

Christine M. Branche, Ph.D. 

Director 




Atlanta, Georgia 

B. Chris Brewster 

San Diego Lifeguard Service 

San Diego, California 

Mike Espino 

American Red Cross 

Health & Safety Services, National Headquarters 

Falls Church, Virginia 

John Fletemeyer, Ph.D. 

Palm Beach Police Department 

Law Enforcement Division 

Palm Beach, Florida 

Ralph Goto 

Water Safety Administrator 

Department of Parks and Recreation 

Honolulu, Hawaii 

Rick Gould 

Safety Officer 

City of Santa Cruz 

Santa Cruz, California 

Brad Keshlear 

Natural Resources Management Branch 

U.S. Army Corps of Engineers 

Atlanta, Georgia 

Fred A. Mael, Ph.D. 

Research Scientist 

The American Institutes for Research 

Washington, District of Columbia 


v

Carl Martinez 

Water Safety Coordinator 

National Park Service 

U.S. Department of the Interior 

Gateway NRA Headquarters 

Brooklyn, New York 

Michael A. Oostman 

Jeff Ellis and Associates, Inc. 

Kingwood, Texas 

Frank Pia 

Pia Consulting Services 

Larchmont, New York 

William Richardson 

President, U.S. Lifesaving Association 

Huntington Beach, California 

Acknowledgments 

For contributing to organizing the meeting, Cecil Threat and La Tanya Butler. For 

assistance in editing the drafts of this report, David A. Sleet, Ph.D., and B. Chris Brewster. 

For compiling and organizing the Resource Guide, Mike Espino and Yvonne Norman. And 

to each member of the working group for their patience in answering what may have 

seemed to be endless questions for clarification. 

vi 

Lifeguard Effectiveness: A Report of the Working Group

Executive Summary 

Each year, about 4,000 people die from drowning in the United States. Drowning was 

a leading cause of unintentional injury death among all ages in 1998, and the second 

leading cause of unintentional injury death among children ages 1-14 that same year. 

Approximately 50-75% of drownings occur in open water such as oceans, lakes, rivers, and 

ponds. About 60% of drowning deaths among children occur in swimming pools. 

Many organizations, including the Centers for Disease Control and Prevention (CDC), 

routinely respond to inquiries regarding the efficacy of lifeguards in preventing drownings. 

Community and local government officials facing decisions about whether to begin, 

retain, or discontinue lifeguarding services typically want to know whether lifeguards are 

truly effective in preventing drowning and other aquatic mishaps, and whether the value 

of providing lifeguard protection outweighs the costs. Most drownings are preventable 

through a variety of strategies, one of which is to provide lifeguards in public areas where 

people are known to swim and to encourage people to swim in those protected areas. 

Some estimates indicate that the chance of drowning at a beach protected by lifeguards 

can be less than one in 18 million. There is no doubt that trained, professional lifeguards 

have had a positive effect on drowning prevention in the United States. 

The significance of the patron surveillance and supervision that lifeguards provide is 

emphasized by understanding how people drown. Many people assume that drowning 

persons are easy to identify because they exhibit obvious signs of distress. Instead, 

people tend to drown quietly and quickly. Children and adults are rarely able to call out 

or wave their arms when they are in distress in the water, and can submerge in 20-60 

seconds. For these reasons, managers should never assign lifeguards duties that distract 

them from keeping an eye on the water, such as selling admission tickets or refreshments. 

In addition, the presence of lifeguards may deter behaviors that could put swimmers at 

risk for drowning, such as horseplay or venturing into rough or deep water, much like 

increased police presence can deter crime. 

When making decisions about using lifeguards and other means of increasing public 

safety in aquatic settings, policy makers should use available local evidence. This 

evidence includes: 

• the effects that lifeguards have had on patrons’ safety and attitudes; 

• the number of people using the facility or beach area during the past years; 

• the incidence of water-related injuries and drownings at the facility or beach area 

during those time periods; 

• data on the number of water-related injuries and drownings at pools and beaches 

in the local area or state with and without lifeguards, for comparison; and 

• the level of lifeguards provided (e.g., number of lifeguards per number of persons 

using the facility). 

In addition to these factors, policy makers should consider public attitudes about lifeguards 

and legal issues related to using lifeguards. 


vii

Introduction 

Each year, about 4,000 people die from drowning in the United States (National Center 

for Health Statistics, 2000). Drowning was a leading cause of unintentional injury death 

among all ages in 1998, and the second leading cause of unintentional injury death 

among children ages 1-14 that same year (National Center for Health Statistics, 2000). 

Approximately 50-75% of drownings occur in open water such as oceans, lakes, rivers, 

and ponds (Dietz & Baker, 1974). About 60% of drowning deaths among children occur in 

swimming pools (Dietz & Baker, 1974). 

Most drownings are preventable through such means as restricting swimming areas, posting 

warning signs, and fencing the perimeters of pools and waterways. Two important 

preventive strategies are providing lifeguards in public areas where swimmers frequent, 

and encouraging use of such protected areas. The United States Lifesaving Association 

(USLA) compiles statistics for drownings that occur at about 95% of ocean beaches and 

at some non-ocean sites patrolled by lifeguards. 1 For the years 1988-1997, USLA recorded 

fewer than 100 drownings at these sites with more than three-quarters occurring during 

hours when the beaches were unguarded (USLA, 2000). These data indicate that the vast 

majority of drownings each year occur at unguarded locations (Mael, Seck, & Russell, 

1999); about 60%-70% of U.S. beaches are unguarded (Brewster & Richardson, 2001). 

USLA statistics estimate that the chance of drowning at a beach protected by lifeguards 

trained under USLA standards is less than one in 18 million per year (USLA, 2001). 2 

The Centers for Disease Control and Prevention (CDC), the American Red Cross and USLA 

routinely respond to inquiries regarding the efficacy of lifeguards in preventing drownings. 

Community and local government officials facing decisions about whether to begin, 

retain, or discontinue lifeguarding services typically want to know whether lifeguards 

are truly effective in preventing drowning and other aquatic mishaps, and whether the 

value of providing lifeguards outweighs the costs. Officials often use cost as the primary 

criterion in their decision-making. 

This report is the result of a 1998 meeting CDC convened with a panel of experts to 

identify gaps in lifeguard effectiveness at recreational waters, and ways to remedy them. 

This meeting was intended as a discussion about the issues related to the provision of 

lifeguards. This working group discussed: 

• the problem of retaining lifeguards and evaluating the efficacy of existing lifeguard 

services; 

• drowning fatalities and other hazards resulting when lifeguards were removed 

from facilities; 

1 

Open water lifeguard agencies submit reports on annual beach attendance, rescues, preventive actions, 

drownings and other information to USLA, which reports lifesaving statistics from eight regions, with 

typically over 85 agencies and beaches reporting (USLA, 2001). 

2 

This calculation is based on ten years of reports from USLA affiliated lifeguard agencies, comparing 

estimated beach attendance to the number of drownings in areas under lifeguard protection. 


1

• the best methods to communicate information about the efficacy of lifeguards to 

relevant constituents; and 

• sources of information about the efficacy of lifeguards, additional data, resources, 

and case studies. 

The report includes a brief history of lifeguarding services in the United States; data 

and findings related to the use of lifeguards in preventing drowning in open water and 

swimming pool facilities; the experience of an agency which does not provide lifeguards 

at its water recreation facilities; and economic and legal issues related to the provision 

of lifeguards. We also provide suggestions for decision makers and alternative solutions 

for preventing drowning. 

Drowning prevention, much like other areas of injury prevention, is a young and emerging 

field. This report aims to stimulate new ideas and approaches. The authors of this report 

hope it is useful to local policy makers who must make vital decisions about the provision 

of lifeguards and other interventions to enhance water safety in their communities. 

2 Lifeguard Effectiveness: A Report of the Working Group

Lifeguarding Services in the United States: 

A Brief History 

In the 1800s, swimming, then known as bathing, became an increasingly popular recreational 

activity in the United States. Entrepreneurs built resorts in places like Atlantic 

City, New Jersey, to attract people from inland cities to escape the summer heat. As water 

activity increased, so did the incidence of drowning. In fact, by the early 1900s as many 

as 9,000 people drowned each year in the United States (American Red Cross, 1995). 

Initial efforts to reduce drownings included installing lifelines. 3 However, lifelines proved 

inadequate because struggling swimmers were not always able to hold on to them. Duke 

Kahanamoku, the famed Hawaiian surfer, introduced the rescue board between 1910 and 

1915, and Captain Harry Sheffield of South Africa is credited with developing the first 

rescue float (American Red Cross, 1995). Some municipalities assigned police officers to 

perform water rescues, but this diverted resources from law enforcement. Eventually, 

municipalities began to hire persons trained and equipped specifically for water rescue. 

They were called “lifeguards.” 

The lack of a consistent lifeguard presence at all bathing areas led the Young Men’s 

Christian Association (YMCA) to develop a volunteer National Lifesaving Service in 1912. 

In 1914, Commodore Wilbert E. Longfellow established the American Red Cross Lifesaving, 

which trained swimmers throughout the United States in lifesaving and resuscitation, 

organized them into a volunteer corps, and encouraged them to accept responsibility for 

supervision of bathing activities in their communities. 

At their inception, these lifesaving training programs primarily emphasized personal 

water safety: how to prevent drownings and protect oneself in emergencies. Nonswimming 

rescue methods, such as throwing a rope or a floating object to the person in the 

water, were encouraged. Lifeguards considered swimming rescues a last resort due to the 

hazard presented by a panicked person in the water. 

However, swimming rescues were unavoidable for professional beach lifeguards in the 

United States. Special tools, such as the landline 4 and the dory, 5 were developed to assist 

in swimming rescues. Over time, improved lifesaving devices were created by beach 

lifeguards in the United States. These include the rescue buoy, the rescue tube, and the 

rescue board 6 which are commonly used around the world at beaches, pools, and water 

parks. Today, many beach lifeguards use powerboats and personal watercraft to assist 

them in reaching off-shore swimmers in distress quickly and use scuba equipment for 

deep water rescues. 

In 1964, the organization now known as the United States Lifesaving Association (USLA) 

was founded by members of several California surf lifeguard agencies originally to 

enhance lifesaving efforts and drowning prevention, to standardize beach lifeguard practices, 

to educate the public about water safety, and to improve professionalism among 

3 

Lifelines are ropes tied onshore and to poles in the ocean water, to which bathers can cling. 

4 

The landline is a rope used by a lifeguard during a swimming rescue. A lifeguard swims with the landline to a 

victim in the water, and people sonshore pull both lifeguard and victim to safety. 

5 

The dory is a small boat rowed out to rescue victims in distress. 

6 

The rescue board is a surfboard modified for rescuing drowning victims. 


3

each lifeguard organizations around the country. Membership has since expanded to 

include any employee of an ocean, bay, lake, river or other open water rescue service 

(Brewster, 2001). In 1980, the World Waterpark Association was formed to address 

needs in aquatic amusement parks. Following this, Ellis and Associates, through the 

National Pool and Waterpark Lifeguard Training program, established specialized waterpark 

lifesaving standards and certification programs. In 1983 and 1986, respectively, the 

American Red Cross and YMCA expanded their training programs to provide nationally 

standardized instruction for lifeguards at both swimming pools and beaches. Local 

employers continue to provide lifeguard training at most surf beaches. The American Red 

Cross, USLA and Ellis and Associates establish standards which are universally adopted 

for lifeguard training. 

Lifeguards have always provided first aid as well as rescue. Cardio-pulmonary resuscitation 

(CPR) and general first aid training are standard requirements for most lifeguards. In 

addition, many lifeguards are now both trained and certified to use advanced lifesaving 

tools such as the external defibrillator and portable oxygen. In some communities, 

lifeguards have taken on broader public safety responsibilities, such as advanced life 

support, coastal cliff rescue, and law enforcement. 

Major aquatic safety organizations in the United States have continually emphasized 

prevention rather than rescue as the primary method to reduce drownings. Public safety 

education and onsite supervision by lifeguards have helped keep drowning rates low for 

40 years, and have significantly reduced the number of drownings in the United States. 

Since 1960, both beach attendance and rescues by lifeguards have risen steadily, although 

the total number of reported drownings on lifeguarded beaches remained relatively stable 

with fewer than 106 cases each year (USLA, 2000). In fact, from 1986 through 1999, USLA 

reported that in California, while beach attendance has increased, so has the amount of 

lifeguard education (See Figure 1 in Appendix) (USLA 2000). Although rescue activity 

fluctuated, the number of drownings is down. 

Estimates indicate that today, U.S. lifeguards rescue more than an estimated 100,000 

persons from drowning annually. USLA data show a rescue-to-drowning ratio in the 

1960s of one drowning for every 2,004 rescues at beaches with on-duty lifeguards. In the 

1990s, however, the ratio improved to one drowning for every 4,832 rescues at lifeguarded 

beaches. In addition, for every rescue, an effective lifeguard makes scores of preventive 

actions, such as warning an individual away from a dangerous area and suggesting 

that poor swimmers stay in shallow water. There is no doubt that trained, professional 

lifeguards have had a positive effect on drowning prevention in the United States. 

While the number of Americans participating in water recreation has grown tremendously 

since the late 1800s and the popularity of aquatic activities has increased, the annual 

incidence of drowning in the United States has declined from about 6,300 persons in 1981 

to about 4,000 persons in 1998 (National Center for Health Statistics, 2000). Nevertheless, 

despite the advances in rescue techniques and the decline in drowning rates in the 

United States, drowning remains a leading cause of unintentional injury death, especially 

among children and youth. If the incidence of drowning is to be reduced further, greater 

attention to prevention, including the staffing and training of lifeguards, is essential. 


Events Describing the Efficacy of Lifeguards 

in Preventing Drowning Deaths 

Evidence suggests that lifeguard services benefit public safety by saving lives, lowering 

drowning rates, and preventing injuries in aquatic recreational environments. Lifeguards 

also indirectly provide economic and social benefits. They add to the savings in emergency 

medical care and long-term hospital treatment involving cases of near-drowning 

(Hassell 1997) and alleviate emotional trauma and social costs to family and friends. 

Communities sometimes choose to discontinue lifeguards as a cost-saving measure. We 

provide a series of case studies to demonstrate the impact of lifeguards on drowning. 

A few caveats are worth noting when considering these case studies. First, geography, 

environmental conditions, demographics, and other local conditions may be factors in 

drownings. Also, national data are not available to assess the number of drownings 

that occur on beaches without lifeguards because no centralized reporting system exists. 

Nonetheless, case studies help illustrate the potential effects of lifeguards on public 

safety. 

Case Sudies 

Case 1: American Beach (Nassau County), Florida 

In 1989 the Nassau County Commission decided to eliminate lifeguards on American 

Beach in order to save county expenses. Less than a year later on Memorial Day, 1990, 

five persons drowned and 20 others nearly drowned when rough ocean conditions and 

strong winds caused rip currents to form immediately offshore, making this one of the 

worst drowning episodes in Florida’s history. Shortly after this tragedy, local officials 

reestablished lifeguarding services. In the eight years since, no one has drowned. 

Case 2: Keawaula Beach, Hawaii 

Keawaula Beach at Kaena Point State Park is located at the westernmost point on the 

island of Oahu. The beach is exposed to high surf; a strong shore break; and a strong, 

often severe, current. The remote, pristine site attracts many surfers, sunbathers, swimmers, 

and waders. The combination of dangerous physical features and heavy use by 

patrons increases the risk for water-related injury and death. From 1985 to 1991, two 

drownings and 40 near-drownings occurred at Keawaula Beach. Although the State of 

Hawaii does not provide lifeguards, it elected to contract with the City and County of 

Honolulu to place lifeguards at Keawaula Beach beginning in January, 1992. Since then, no 

drownings have occurred at this beach. 

Case 3: Ocean Beach, San Francisco, California 

Ocean Beach covers more than five miles of the Pacific shore in the City and County 

of San Francisco. Rip currents are common in the water off this beach. The beach is 

administered by the U.S. National Park Service and is part of the Golden Gate National 

Recreation Area (GGNRA). Until the early 1990s, GGNRA provided lifeguards at several 

beaches in the region, including Stinson Beach, China Beach, and Aquatic Park near 


5

Fisherman’s Wharf, with occasional patrols and emergency response to Ocean Beach. 

As a result of budgetary concerns, lifeguards for Aquatic Park, China Beach, and Ocean 

Beach were gradually removed in the early 1990s. However, the beach-going public 

continued to swim at Ocean Beach, and drownings continued to occur, despite the 

development of an aquatic response team by the San Francisco Fire Department, which 

accomplished a number of rescues. During the late spring and early summer of 1998, 

there were seven drownings at Ocean Beach, which exceeded the previous six-year total. 

These drownings generated extensive media attention and resulted in calls by several 

major groups and prominent individuals for lifeguard protection. GGNRA consulted with 

USLA to develop a plan to employ, train, and deploy aquatic rescue personnel at Ocean 

Beach. On-site lifeguard services began before the summer of 1999, and since that time, 

no drownings have occurred at Ocean Beach. 

Case 4: Ocean Beach, San Diego, California 

In 1918, 13 people drowned in rip currents in a single day at San Diego’s Ocean Beach, 

garnering local and national news attention. Beach attendance that day was estimated at 

5,000. City officials cited inadequate lifeguard protection as a cause of the tragedy, and 

as a result, initiated a municipal lifeguard service. The ocean conditions have changed 

little since then. San Diego’s local leaders view the 17 miles of oceanfront shoreline, 

which include Ocean Beach, as a safely managed tourist attraction due to the presence of 

lifeguards. Despite an average estimated annual attendance of 15 million people and over 

7,000 rescues at the major lifeguarded beaches, the average number of drownings in areas 

under lifeguard protection is between zero and one annually. 


Patron Surveillance: A Key Component 

of Lifeguarding Services 

Lifeguards play an important role in a swimming facility’s risk management program. 

Lifeguards are trained to monitor the aquatic environment, supervise patrons, inform 

patrons about the potential for injury, educate them about the consequences of injuryproducing 

behavior, and enforce rules and regulations that prevent injuries. They are 

also, of course, expected to perform rescues to prevent drownings and to provide immediate 

first aid and CPR. But to do so, they must first identify persons who are in distress 

in the water. 

Patron surveillance is key to preventing aquatic injury. It involves maintaining a constant 

watch over persons both in and out of the water and over the aquatic facility in order 

to identify circumstances that may cause injury. Action can then be taken to prevent 

or minimize injury. For example, a lifeguard may notice a small child playing alone in 

the water near a known drop-off and intervene before the child steps in water that is 

too deep. A lifeguard may also observe a person struggling in the water and perform a 

timely rescue. 

The importance of lifeguards providing patron surveillance, especially monitoring the 

behavior of swimmers, can be demonstrated with a brief description of how persons 

drown. Many people assume that drowning persons are easy to identify because they 

will exhibit obvious signs of distress in the water, such as yelling or waving their arms. 

However, this kind of behavior is not common. Instead, people tend to drown in more 

quiet, less attention-getting ways. Drowning persons usually struggle to keep their mouth 

above the surface of the water in order to breathe. Struggling to stay afloat and possibly 

suffocating, they are rarely able to call out or wave their arms. Observational studies 

of persons at flat water (non-surf) beaches have revealed that non-swimming adults who 

find themselves in water over their heads are generally able to struggle on the surface of 

the water for about 60 seconds, while infants and very small children can submerge in as 

little as 20 seconds. These characteristics of drowning -- the inability of a person to call 

or wave for help and the short time period before submerging -- emphasize the need for 

lifeguards as a source for continuous surveillance and immediate action. 7 

However, supervisors and managers at aquatic facilities sometimes make the mistake of 

assigning lifeguards unrelated duties to perform while also expecting them to conduct 

effective patron surveillance. Because drowning can occur quickly and quietly, it is not 

surprising that lifeguards, distracted from keeping an eye on the water by other assigned 

duties, have failed to spot drowning persons in time to rescue them. Indeed, unobserved 

drownings have occurred even while lifeguards were stationed 20 feet from the water, 

taking tickets of those entering the facility or selling refreshments. It is clear, therefore, 

that swimming facilities must be staffed adequately to ensure effective and continuous 

patron surveillance, and that lifeguards should be given no other task that would 

distract them from this work. This concept is also supported by the USLA. The USLA 

7 

These characteristics of persons in distress in the water have been called the Instinctive Drowning 

Response by Pia (Pia F., 1971, On Drowning, 2 nd rev. ed, Water Safety films, Inc., Larchmont, NY; Pia F., 

1974 Observations on the drowning of nonswimmers. Journal of Physical Education, The YMCA Society of 

North America, Warsaw, IN). 


7

equires lifeguard agencies seeking USLA certification to adhere to the following principles: 

“Lifeguards assigned to supervise an aquatic area shall not be subject to duties 

that would distract or intrude their attention from proper observation of persons in the 

waterfront area, or that prevent immediate assistance to persons in distress in the water. 

Specifically, lifeguards assigned to water surveillance shall not be assigned to any duties 

other than public safety” (USLA, 2000). 


Use of Design Criteria to Reduce Drownings 

at Lakefront Facilities 

Although providing quality lifeguarding services at water recreational facilities is effective 

in preventing drowning, some decision makers may elect not to hire lifeguards. In that 

case, environmental modifications to the facility can still improve safety for patrons. This 

section describes some environmental design changes that one water recreation provider 

used to reduce drownings at facilities that did not employ lifeguards. 

The U.S. Army Corps of Engineers is the second largest provider of outdoor recreation 

facilities in the United States, managing more than 7 million surface acres of water and 

4.5 million acres of land. Corps lakes are located in 43 states, and in 1998 staff recorded 

2.6 billion visitor hours at these lakes. Approximately 58% of these hours (1.5 billion 

hours) are attributable to water recreation, such as swimming, wading, boating, water 

skiing, and fishing. 

As a policy developed to limit liability, the Corps does not assign lifeguards to its facilities; 

it has a “swim at your own risk” policy. However, to reduce the number of drownings 

occurring at its beaches, the Corps established specific design criteria for its lakefront 

swimming beaches in 1987. These design criteria appear to have helped. Between 1971 

and 1987, before the criteria were implemented, an average of 330 swimmers drowned 

each year. The design criteria were introduced between 1988 and 1998, and over that 

decade the yearly average fell to 183 drownings. These criteria are intended for inland 

lakes rather than surf beaches, where surf action makes them difficult to implement. 

The majority of the design criteria for Corps swimming beaches relate to environmental 

controls. The priorities in the design of a beach are safety of the user, effects the 

physical features of the site will have on the beach, and future operation and maintenance 

considerations. 

The Corps design criteria include estimating expected patron visitation levels; providing 

access for disabled persons; creating slope gradients that gradually and smoothly lead 

to deeper water; making efforts to ensure that the swimming area is protected from 

possible sources of contamination; maintaining consistent water levels; prohibiting diving 

platforms and swim floats; using buoys and markers to delineate the swim area and 

keep boats out; and ensuring the availability of additional safety measures such as rings, 

buoy lines, and poles. The complete design criteria for Corps swimming beaches can 

be found in Engineer Manual [EM -1110-1-400], Recreation Planning and Design Criteria, 

July 31, 1987. 

The U.S. Army Corps of Engineers also supports a comprehensive water safety information 

campaign. Corps employees who work in water safety throughout the United 

States develop a coordinated, annual water safety campaign. Evaluations of previous 

campaigns allow the Corps to identify specific water safety issues each year for a fullscale 

educational campaign at all its facilities. The campaigns include print and television 

public service announcements. Many of the messages target school-aged children, a 

high-risk group. 


9

Economic Costs of Drowning Deaths 

Public safety education and onsite supervision by lifeguards have helped keep drowning 

rates low for 40 years, and have significantly reduced the number of drownings in the 

United States. Still, the cost of a single catastrophic injury or death while using an 

aquatic facility can be substantial. Experts have described the costs of unintentional 

death through two measures. The economic costs framework measures the victim’s 

productivity loss and the expenses related to the event. 8 Comprehensive costs include 

the economic loss, as well as the value of lost quality of life associated with the death 

or injury. 

In 1997, the National Safety Council placed the economic value of each unintentional 

injury death at $790,000 and the comprehensive cost at $2,790,000 (National Safety 

Council, 1997). Using the drowning figures from beaches in the USLA reporting system, 

the comprehensive costs of drowning on coastlines in 1997 amounted to $273,420,000. 

From 1960 to the present, the total cost of drowning deaths at these USLA beaches is 

estimated to have been $4.2 billion. Factoring in costs of drowning in other aquatic 

facilities and the estimated annual cost of $138,000 per incapacitating injury, and the 

$180,000 annual cost for a catastrophic injury, the total costs of unintentional injury begin 

to climb geometrically. For comparison, salaries and benefits (typically 50% of costs) for 

full-time beach lifeguards range from $26,500 to $32,000 in Hawaii, Southern California and 

South Florida, where lifeguards work year-round. It is clear that providing a safe aquatic 

environment and instituting programs to prevent aquatic injury or death offer significant 

economic and social savings to society as a whole. 

Although water-related injuries and drownings already result in tremendous costs, they 

would be substantially higher without lifeguards. One way of describing these costs is 

to estimate that one percent of the total rescues made by lifeguards would have resulted 

in a drowning death in the absence of lifeguards. In 1997, USLA recorded approximately 

77,000 rescues for areas served by lifeguards. If one percent of these rescues (770) had 

instead resulted in death, either because the rescue had not taken place or because there 

were no lifeguards, then the economic cost of these deaths would be more than $600 

million, and the comprehensive cost would exceed $2.1 billion. 9 

Using the same assumption, that one percent of the rescues instead resulted in incapacitating 

injuries (i.e., ones that would disable persons and permanently prevent them 

from performing some or all work), would yield a cost of approximately $4.1 billion 

per year over and above initial economic or comprehensive costs. If one percent of 

the rescues had instead resulted in nonincapacitating injuries (i.e., ones that required 

medical care or hospitalization but would not result in disability), then the anticipated 

cost would be about $10.7 million for economic costs per year and $27.5 million per year 

for comprehensive costs. Table 1 in the Appendix includes cost estimates for different 

models using a lifeguard rescue effectiveness ranging between 1% and 36%. 

8 

Included in the components of economic losses are: wages and productivity; medical expenses; administrative 

expenses of law enforcement, legal fees and insurance costs; and employer costs. 

9 

These figures do not estimate the costs of converting a death to an incapacitating injury because of a 

rescue. 


11

While these estimates help demonstrate the range of costs of drownings and waterrelated 

injuries and the benefits of prevention on a national scale, the numbers may be so 

large that they do not assist decision makers working with a single, community facility. 

Mael, Seck, and Russell (1999) provide a helpful method of estimating costs on a smaller 

scale by converting the ratios to a given baseline of 10,000 patrons. They estimate the 

number of rescues needed if no preventive actions are taken, the number of injuries 

if there are no rescues, and the number of drownings if there are no rescues (i.e., no lifeguards 

present to intervene). This method provides minimum and maximum estimates of 

both the economic and the comprehensive costs of drownings and injuries at unprotected 

sites. They calculate that the total economic costs for not having lifeguards per 10,000 

patrons ranges from $202,500 to $4.6 million and the total comprehensive costs per 10,000 

patrons ranges from $705,380 to $16.1 million (see Table 2 in Appendix). 


Legal Implications of Providing Lifeguard Protection 

The decision to provide lifeguard protection can be influenced by civil liability laws, 

which may hold the owners of aquatic areas and the lifeguards they employ responsible 

for fatal and nonfatal injuries. 

One aspect of liability involves malfeasance. In most states, lifeguards, like other safety 

providers, are expected to act within a standard of care set by their training, local 

protocols, and past court rulings. A variation from the standard of care may result 

in liability. Another aspect of liability involves the condition of the facility and the 

quality of warning or protection provided. Some laws absolve federal, state, or local 

governments of liability for injuries resulting from natural conditions, such as currents 

and surf action. In California, for example, local governments are immune from injuries 

sustained at beaches as a result of natural conditions, regardless of the presence or 

absence of lifeguards or warning signs. This approach neither discourages nor encourages 

the placement of lifeguards. 

Some state laws hold governments liable for natural conditions under certain circumstances. 

The Supreme Court of Hawaii (Kaczmarczyk vs. City and County of Honolulu, 

1982) has determined that while a municipality is not an insurer of the safety of those 

using public beaches and adjacent waters, governments must exercise reasonable care in 

maintaining these facilities and in supervising their use by the public. 

The court has found that the municipality has a duty to warn of extremely dangerous 

conditions known to the municipality which would not be obvious to an ordinary person. 

One method of warning is the placement of signs, and Hawaii is assessing the adequacy 

of warning by signage. 

In Florida, municipalities have discretionary authority to operate a designated swimming 

area at a beach, but once they decide to operate a swimming facility, they assume a 

common law duty to operate it safely. In determining liability for drownings, Florida 

courts look for a previous knowledge of the danger, the presence of lifeguards, and the 

adequacy of warnings. Generally, a private Florida landowner, such as a hotel owner, has 

no duty to post lifeguards on public beaches or warn guests of hazardous ocean conditions. 

If, however, the hotel designates the beach as a swimming area, it incurs a duty to 

provide adequate warnings and safety precautions. Even if an area is not designated as 

a swimming area, a duty still may be placed on the landowner to operate the area safely 

through local ordinances or contractual agreements with beach vendors. 

Liability definitions categorize swimming pools into those open to the public, those 

accessible by fee, and those provided by hotels. For public pools, some states and local 

jurisdictions specifically define the required level of lifeguard protection. In other areas, 

the level of protection may be left to the pool owner, but in the case of an incident, 

assessing the quality of protection may be a matter of what is considered reasonable 

by a judge or jury. In most states, hotels must simply post signs with approved or 

commonly accepted language. This passive approach to water safety may limit liability, 

but it also limits injury prevention. It is clear that lifeguards can significantly reduce the 


13

incidence of water-related injury and death. Therefore, laws which encourage placement 

of lifeguards, although more expensive, can logically be expected to enhance public 

safety. 


Decision Maker’s Guide to Lifeguard Protection 

The decision to protect the public in an aquatic facility, either by providing lifeguards 

or using another preventive strategy such as signage, requires careful assessment of the 

alternatives available to the facility or jurisdiction. This section offers some suggestions 

about how decision makers might approach such a choice and frame the alternatives. 

In order to assist in evaluating the need for providing lifeguards in a facility or local 

jurisdiction, consider these steps: 

(1) Use any relevant data available on the facility or jurisdiction. Data may include: 

• The number of people using the facility or beach area during past years; 

• The incidence 10 of water-related injuries and drownings at the facility or beach 

during those times; 

• The number of water-related injuries and drownings at pools and beaches in 

the locality or state with and without lifeguards, for comparison; and 

• the level of lifeguards provided (e.g., number of lifeguards per number of 

persons using the facility). 

(2) If lifeguards are already provided, then ask the questions: 

• How have lifeguards affected patrons’ safety and attitudes? 

• Is the drowning rate increasing, decreasing, or has it remained unchanged? 

(3) Assess proposed alternatives (e.g., hiring lifeguards, placing warning signs, modifying 

the aquatic environment or restricting access to the facility). As various 

alternatives are developed, use history and precedence to assess them. 

• Try to estimate the cost-effectiveness of each alternative. 

• Assess legal implications and opinions that are critical to the issue and the 

alternatives. 

10 

Incidence is the number of drownings (or number of water-related injuries) divided by the total number of 

visitors at the facility or jurisdiction, multiplied by the period of time in question (e.g., 1 year). 


15

Summary and Conclusions 

When making choices about drowning prevention interventions in their areas, decision 

makers must balance a sincere desire to protect the public with “real-world” issues of 

budgets and legal liability. In this report, we have attempted to provide useful information 

and relevant questions that can be applied when making these decisions. One effective 

drowning prevention intervention is to provide trained, professional lifeguards to 

conduct patron surveillance and supervision at aquatic facilities and beach areas. 

USLA data during 1988-1997 indicate that more than three-quarters of drownings at USLA 

sites occurred at times when beaches were unguarded and that the chances of drowning 

at a beach protected by lifeguards trained under USLA standards is less than one in 18 

million. The four case studies provided in this report also describe the positive impact 

of lifeguards at beaches where multiple drownings had occurred when unguarded. When 

lifeguards are employed, it is vital that they be trained effectively in detecting persons in 

distress, and when assigned to water surveillance not be given duties other than public 

safety. The presence of lifeguards may deter behaviors that could put swimmers at 

risk for drowning, such as horseplay or venturing into rough or deep water, much like 

increased police presence can deter crime. Also, the experiences of the U.S. Army Corps 

of Engineers suggests that environmental design changes (at inland lakes) and safety 

information campaigns can also play a role in reducing drowning deaths. Owners and 

managers of natural water recreation venues should consider these design characteristics, 

regardless of the presence or absence of lifeguards. 

Regardless of the evidence, or lack thereof, of lifeguard effectiveness, some communities 

insist on lifeguard services, based on local circumstances. Policy makers need to make 

use of the available local evidence and consider public attitudes and the legal environment 

when making decisions about lifeguard services and other means for increasing 

public safety in aquatic settings. Providing a safe aquatic environment and instituting 

programs to prevent water-related injury or death offer significant economic savings. 

Table 2 in the Appendix can serve as a useful tool for estimating the human and economic 

impact of not providing lifeguards. 

Finally, if a community develops water recreational facilities to attract patrons who spend 

money in the local area, then it can be argued that the community has an obligation to 

protect these patrons. When weighing the costs and legal implications of interventions to 

prevent drowning, decision makers should never lose sight of the enormous importance 

of protecting people from harm and preventing tragedy at beaches and pools, places 

where people go for pleasure, for health, and for solace. 


17

References 

American Red Cross (1995). Lifeguarding Today, St. Louis, Missouri: Mosby Lifeline. 

Brewster, B. Chris (July 13, 2001). Personal communication. 

Brewster, B. Chris & Richardson, William (August 10, 2001). Personal communication. 

Davis, P. (1988). “Sea of Trouble,” XS Magazine, pp15-20. 

Dietz, P.E. & Baker, S.P. (1974). Drowning: Epidemiology and Prevention. American 

Journal of Public Health, 64, pp 303-312. 

Fletemeyer, J. & Dean, R. (1994). The Anatomy of a Hazardous Beach Sea Symposium 1994, 

Panama City, Florida. 

Fletemeyer, J. & Wolfe, G. (1994). Panama Beach Safety Study. Report by Florida Beach 

Patrol Chiefs Association and the Southeast Region, United States Lifesaving Association, 

Ft. Lauderdale, Florida. 

Hassell, C.A. (1996). Pediatric Drowning Prevention Awareness Program. Masters thesis. 

Lynn University, Palm Beach, Florida. 

Kaczmarczyk vs City and County of Honolulu (1982). State of Hawaii, No. 7191, 65 Haw. 

612, 656 P.2d 89. 

Mael, F., Seck, M. & Russell, D. (1999). A Work Behavior-Oriented Job Analysis for 

Lifeguards (Final Technical Report). American Institutes for Research, Washington, DC. 

National Center for Health Statistics, Vital Statistics of the United States, Mortality, Underlying 

and Multiple Causes of Death, Public Use Files (2000). Hyattsville, Maryland: NCHS. 

National Safety Council (1997). Accident Facts, 1997 edition. Itasca, Illinois: National 

Safety Council. 

Pia, F. (1971). On Drowning, 2 nd Rev. Ed, Water Safety Films, Inc., Larchmont, New York. 

Pia, F. (1974). Observations on the Drowning of Nonswimmers. Journal of Physical 

Education, The YMCA Society of North America, Warsaw, Indiana. 

United States Lifesaving Association (ed. 2000). USLA Open Water Lifeguard Agency 

Certification Program, Huntington Beach, California. 

United States Lifesaving Association. 1999 National Lifesaving Statistics. Available at 

www.usla.org/PublicInfo/stats.shtml. Accessed July 13, 2001. 


Resource Guide 

Organizations and Associations that Promote Lifeguarding and Water Safety 

American Alliance for Health, Physical 

Education, Recreation and Dance 

(AAHPERD) 

1900 Association Drive 

Reston, Virginia 22091 

(703) 476-3400 

American Red Cross 

Health and Safety Division 

8111 Gatehouse Rd. 

Falls Church, Virginia 22042 

(703) 206-7180 

BOAT/U.S. Foundation 

880 S. Pickett Street 

Alexandria, Virginia 22304 

(703) 823-9550 

Boy Scouts of America 

1352 Walnut Hill Lane 

Irving, Texas 75038-3096 

(214) 580-2000 

The Canadian Red Cross Society 

1800 Alta Vista Drive 

Ottawa, Ontario 

Canada K1G4J5 

(613) 739-3000 

The Commodore Longfellow Society 

2531 Stonington Rd. 

Atlanta, Georgia 30338 

Girl Scouts of America 

420 Fifth Avenue 

New York, New York 10018 

(212) 852-5720 

Jeff Ellis and Associates, Inc. 

3506 Spruce Park Circle 

Kingwood, Texas 77345 

(713) 360-0606 

National Intramural and Recreational 

Sports Association (NIRSA) 

850 SW 15th Street 

Corvallis, Oregon 97333 

(503) 737-2088 

National Recreation and Park Association 

(NRPA) Aquatic Section 

650 West Higgins Road 

Hoffman Estates, Illinois 60195 

(708) 843-7529 

National Association of State 

Boating Law Administrators (NASBLA) 

Box 11099 

Lexington, Kentucky 40512-1009 

National Safe Boating Council 

2911 Russell Road 

Ostrander, Ohio 43061 

(614) 666-3009 

National Water Safety Congress 

Administrative Services 

1181 Shake Rag Road 

Buckhead, Georgia 30625 

(706) 342-3775 

The Royal Life Saving Society Australia 

P.O. Box 1567 

North Sidney, NSW 2059 

02-957-4799 

FX 02-929-5726 

The Royal Life Saving Society Canada 

287 McArhur Ave. 

Ottawa, Ontario 

Canada K1L 6P3 

(613) 746-5694 


19

The Royal Life Saving Society UK 

Mountbatten House 

Studley 

Warwickshire 

B80 7NN United Kingdom 

+ 0527 853943 

U.S. Army Corps of Engineers 

Safety Office 

20 Massachusetts Avenue, NW 

Washington, DC 20314-1000 

(202) 761-8600 

United States Coast Guard (USCG) 

Commandant (G-NAB) 

2100 Second Street, SW 

Washington, DC 20593-0001 

United States Coast Guard Auxiliary 

3131 North Abingdon Street 

Arlington, Virginia 22207 

United States Lifesaving Association 

P.O. Box 366 

Huntington Beach, California 92648 

www.usla.org 

YMCA of the U.S.A. 

101 North Wacker Drive 

Chicago, Illinois 60606 

1-800-872-9622 

YWCA of the U.S.A. 

726 Broadway 

New York, New York 10003 

(212) 614-2700 

World Waterpark Association 

P.O. Box 14826 

Lenexa, Kansas 66285-4826 

(913) 599-0300 


Appendix 

Figure 1 

California Beach Activity 1986–1999 


21

Table 1 

Estimated Cost if Percent of 770,000 Reported Rescues in 1997 

Had Not Been Made by Lifeguards* 

Percentages: 1% 5% 10% 16% 20% 36% 

Economic costs of deaths $609,130,000 $3,045,650,000 $6,091,295,000 $9,746,072,000 $12,182,590,000 $21,928,662,000 

Comprehensive costs of deaths $2,151,230,000 $10,756,150,000 $21,512,295,000 $34,419,672,000 $43,024,590,000 $77,444,262,000 

Economic costs of incapacitating injury $31,767,000 $158,836,000 $317,673,000 $508,276,000 $635,345,000 $1,143,621,000 

Comprehensive costs of incapacitating 

injury $106,405,000 $532,000,000 $1,064,050,000 $1,702,478,000 $2,128,100,000 $3,830,576,000 

Monthly costs of incapacitating injury** $4,163,700,000 $20,818,350,000 $41,636,700,000 $66,618,720,000 $83,273,400,000 $149,892,120,000 

Economic costs of nonincapacitating 

injury $10,718,000 $53,588,000 $107,176,000 $171,482,000 $214,352,000 $385,833,000 

Comprehensive costs of 

nonincapacitating injury $27,527,000 $137,632,000 $275,265,000 $440,424,000 $550,530,000 $990,953,000 

Source: USLA rescue data. 

* Percentages represent assumed percent of deaths or injuries that would occur if rescues were not performed. 

** $15,000 per month, assumption of 30 years continued life = $5,400,000 


Table 2 

Number of Preventive Actions, Events Requiring Rescues, Drownings, Injuries, 

Costs and Estimated Savings for Every 10,000 Beach Patrons 

Maximum Estimates: Economic Cost Comprehensive Cost 

Preventive actions 97.4 

Number of rescues if no 

preventive action 35.0 

Number of (nonincapacitating) 

injuries if no rescues 12.6 $175,450 $450,600 

Number of drownings if 

no rescues 5.6 $4,431,640 $15,650,960 

Total Savings for each 10,000 Patrons $4,607,090 $16,101,560 

Minimum Estimates: Economic Cost Comprehensive Cost 

Preventive actions 97.4 

Number of rescues if no preventives 4.9 

Number of (nonincapacitating) 

injuries if no rescues 0.73 $10,150 $26,080 

Number of drownings if no rescues 0.25 $192,350 $679,300 

Total Savings for each 10,000 Patrons $202,500 $705,380 


23

Lifeguard Effectiveness: A Report of the Working Group

Transform your PDFs into Flipbooks and boost your revenue!

Delete template?

Save as template ?